Long-term survival analysis in metastatic melanoma: Serum S100B is an independent prognostic marker and superior to LDH

Background: The prognosis of metastatic melanoma is poor. The purpose of this study was to perform a long-term survival analysis on patients with advanced melanoma to determine clinical and laboratory prognostic factors for treatment outcome and long-term survival. The prognostic importance of S100B serum levels on overall survival compared to lactate dehydrogenase (LDH) was evaluated. Patients and Methods: The medical records of 105 AJCC (American Joint Committee on Cancer) stage IV melanoma patients from 1994 to 2001 were analyzed retrospectively. Median time to progression and overall survival were assessed. Univariate and multivariate analysis were performed to determine prognostic factors. Results: 86 (81.9%) of the 105 patients died during the observation period. In univariate analysis, pre-therapeutic LDH and S100B levels in serum samples (p = 0.01 and p = 0.002, respectively), tumor stage (AJCC IVa-IVc, p = 0.005), and response to the first-line therapy (p < 0.001) were found to be significant prognostic markers. However, in the multivariate analysis, pretherapeutic S100B serum levels (p = 0.005, odds ratio (OR): 2.22, confidence interval (CI): 1.22 - 4.1) as well as presence of brain metastases (p = 0.009, OR: 5.08, CI: 1.51 - 17.05) were the only independent prognostic factors for overall survival. Conclusion: In metastatic melanoma, S100B is a strong prognostic factor for overall and long-term survival, and superior to LDH.